Richard Estes is pleased with the care his father, Bill, 79, received after open-heart surgery earlier this year at Kansas University Hospital in Kansas City, Kan.

"It's been wonderful," said Richard Estes, of Osage City. "They explain everything; they tell you when they're going to do it."

That kind of satisfaction is more widespread for inpatient visitors at KU Hospital than it is at the 18 outpatient doctors' clinics scattered around the KU Medical Center complex near 39th Street and Rainbow Boulevard. The hospital rates in the top 10 percent compared with its peers in terms of patient satisfaction, while the clinics rate in the lower one-third for patient satisfaction when compared with other academic medical centers.

"They think of us all as one, but the level of service received is not always consistent," said Bob Page, KU Hospital senior vice president and chief operating officer.

That discrepancy might become smaller under the terms of a new agreement the hospital and the medical center are working out to shape their future relationship. Under a tentative plan, the doctors' group that runs the outpatient clinics, the 350-member Kansas University Physicians Inc., would be removed from the exclusive control of the KU School of Medicine, and KU Hospital would have a say in how the outpatient clinics are run.

Hospital leaders say they have higher patient satisfaction because they emphasize customer-friendly practices - from admission to discharge.

"We've made an issue of customer service, of treating the patient with respect and making the patient experience the least stressful we can. We have built that into systems. We have constant checks: 'Are your needs being met?'" said Dennis McCulloch, a KU Hospital spokesman. "Things like that are not happening in the operation of the clinical setting. Quality of patient care is not seen as a priority throughout the university side."

Kirk Benson, a physician who is president of KU Physicians Inc., disputes that patient care hasn't been a high priority for the School of Medicine. He said one of the greatest areas of patients' dissatisfaction is with the clinics' facilities, not the care itself.

But he acknowledges that the hospital has "had a more organized effort as an enterprise" to boost the quality of patient care.

"We want to achieve that same level of customer service and satisfaction," he said.

Under the structure being proposed, KU Hospital and the KU School of Medicine would have equal representation on the outpatient clinics' board. The doctors who work only at the hospital - in areas such as cardiology and the emergency room - would merge with the members of the outpatient group to form one doctors' organization.

Page, the hospital vice president, said one goal is to create a medical records system that spans the hospital and clinics so that people don't have to give their information to doctors again and again.

"We see a much more positive experience for our patients as they access what we believe is tremendous care here at KU," Benson said. "Right now we have different billing systems, different accounting platforms. How patients move through a clinic and then access the hospital for lab services and X-ray services, it's not as coordinated as it could be."